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2
Free triiodothyronine (FT3)-to-free thyroxine (FT4) ratio identified as a risk factor for gestational diabetes in euthyroid pregnant women: insights from a Chinese population cohort study.游离三碘甲状腺原氨酸（FT3）与游离甲状腺素（FT4）比值可作为甲状腺功能正常孕妇发生妊娠期糖尿病的危险因素：来自中国人群队列研究的新发现。
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Somatostatin inhibits rat hepatic T4-5'-deiodinase. The effect is independent of the associated hypoinsulinemia.生长抑素抑制大鼠肝脏的T4-5'-脱碘酶。该作用与伴发的低胰岛素血症无关。
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J Clin Endocrinol Metab. 2019 Jul 1;104(7):2593-2600. doi: 10.1210/jc.2018-02328.

本文引用的文献

1
Low Thyroid Hormone in Early Pregnancy Is Associated With an Increased Risk of Gestational Diabetes Mellitus.孕早期甲状腺激素水平低与妊娠期糖尿病风险增加有关。
J Clin Endocrinol Metab. 2016 Nov;101(11):4237-4243. doi: 10.1210/jc.2016-1506. Epub 2016 Sep 1.
2
Free Thyroxine During Early Pregnancy and Risk for Gestational Diabetes.孕早期游离甲状腺素与妊娠期糖尿病风险
PLoS One. 2016 Feb 24;11(2):e0149065. doi: 10.1371/journal.pone.0149065. eCollection 2016.
3
Maternal hypothyroxinaemia in pregnancy is associated with obesity and adverse maternal metabolic parameters.孕期母体甲状腺素水平过低与肥胖及不良母体代谢参数相关。
Eur J Endocrinol. 2016 Jan;174(1):51-7. doi: 10.1530/EJE-15-0866.
4
Increasing maternal obesity is associated with alterations in both maternal and neonatal thyroid hormone levels.孕妇肥胖率上升与母体和新生儿甲状腺激素水平的改变有关。
Clin Endocrinol (Oxf). 2016 Apr;84(4):551-7. doi: 10.1111/cen.12974. Epub 2015 Dec 16.
5
An Inverse Relationship Between Weight and Free Thyroxine During Early Gestation Among Women Treated for Hypothyroidism.甲状腺功能减退症治疗女性孕早期体重与游离甲状腺素之间的负相关关系。
Thyroid. 2015 Aug;25(8):949-53. doi: 10.1089/thy.2015.0085. Epub 2015 Jun 23.
6
Does fasting or postprandial state affect thyroid function testing?禁食或餐后状态会影响甲状腺功能测试吗？
Indian J Endocrinol Metab. 2014 Sep;18(5):705-7. doi: 10.4103/2230-8210.139237.
7
Ectopic fat in insulin resistance, dyslipidemia, and cardiometabolic disease.胰岛素抵抗、血脂异常和心脏代谢疾病中的异位脂肪。
N Engl J Med. 2014 Sep 18;371(12):1131-41. doi: 10.1056/NEJMra1011035.
8
Implications of High Free Thyroxine (FT4) concentrations in euthyroid pregnancies: the FaSTER trial.甲状腺功能正常的妊娠中游离甲状腺素（FT4）浓度升高的影响：FaSTER试验
J Clin Endocrinol Metab. 2014 Jun;99(6):2038-44. doi: 10.1210/jc.2014-1053. Epub 2014 Feb 28.
9
Triiodothyronine and free thyroxine levels are differentially associated with metabolic profile and adiposity-related cardiovascular risk markers in euthyroid middle-aged subjects.三碘甲状腺原氨酸和游离甲状腺素水平与代谢特征以及甲状腺功能正常的中年人群中与肥胖相关的心血管风险标志物呈不同相关。
Thyroid. 2014 Feb;24(2):223-31. doi: 10.1089/thy.2013.0314. Epub 2013 Nov 14.
10
Moderate weight loss is sufficient to affect thyroid hormone homeostasis and inhibit its peripheral conversion.适度减重足以影响甲状腺激素的内环境稳定并抑制其外周转化。
Thyroid. 2014 Jan;24(1):19-26. doi: 10.1089/thy.2013.0055.

外周脱碘酶活性：母体体重与妊娠期高血糖之间关联的一种潜在解释。

Peripheral deiodinase activity: A potential explanation for the association between maternal weight and gestational hyperglycemia.

作者信息

Haddow James E, Lambert-Messerlian Geralyn, Eklund Elizabeth, Neveux Louis M, Palomaki Glenn E

机构信息

Department of Pathology and Laboratory Medicine, Division of Medical Screening and Special Testing, Women and Infants Hospital/Alpert Medical School of Brown University, Providence, RI, USA.

Savjani Institute for Health Research, Windham, ME, USA.

出版信息

Obstet Med. 2018 Jun;11(2):73-78. doi: 10.1177/1753495X17733223. Epub 2017 Oct 12.

DOI:10.1177/1753495X17733223
PMID:29997689
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6038021/
Abstract

BACKGROUND

High maternal weight is known to associate with both low free thyroxine and gestational diabetes mellitus. We explore a deiodinase-related mechanism that may help explain these associations.

METHODS

Among 108 women receiving routine oral glucose tolerance testing for gestational diabetes mellitus, we collected biophysical data and measured free thyroxine and total triiodothyronine, using residual plasma samples.

RESULTS

Fasting triiodothyronine/free thyroxine ratio and triiodothyronine were higher among women with gestational diabetes mellitus ( = 0.02;  = 0.04). The triiodothyronine/free thyroxine ratio and triiodothyronine measurements at 2 h were associated with weight ( = 0.20,  = 0.04;  = 0.22,  = 0.02); free thyroxine showed a non-significant inverse weight relationship ( = -0.06,  = 0.55). Glucose at all four intervals was associated with triiodothyronine/free thyroxine ratios, and triiodothyronine at 2 h. In stepwise regression, triiodothyronine/free thyroxine ratio predicted glucose more strongly than did weight.

CONCLUSION

These relationships may be explained by higher maternal weight inducing peripheral deiodinase activity, resulting in higher plasma glucose (via triiodothyronine stimulation) and thereby increasing gestational diabetes mellitus risk.

摘要

背景

已知孕妇体重过高与游离甲状腺素水平低和妊娠期糖尿病均有关联。我们探究了一种可能有助于解释这些关联的脱碘酶相关机制。

方法

在108名接受妊娠期糖尿病常规口服葡萄糖耐量试验的女性中，我们利用剩余血浆样本收集了生物物理数据，并测量了游离甲状腺素和总三碘甲状腺原氨酸。

结果

妊娠期糖尿病女性的空腹三碘甲状腺原氨酸/游离甲状腺素比值和三碘甲状腺原氨酸水平更高（P = 0.02；P = 0.04）。2小时时的三碘甲状腺原氨酸/游离甲状腺素比值和三碘甲状腺原氨酸测量值与体重相关（P = 0.20，P = 0.04；P = 0.22，P = 0.02）；游离甲状腺素与体重呈非显著负相关（P = -0.06，P = 0.55）。所有四个时间点的血糖均与三碘甲状腺原氨酸/游离甲状腺素比值以及2小时时的三碘甲状腺原氨酸相关。在逐步回归分析中，三碘甲状腺原氨酸/游离甲状腺素比值比体重更能有力地预测血糖。

结论

这些关系可能是由于孕妇体重增加导致外周脱碘酶活性增强，从而使血糖升高（通过三碘甲状腺原氨酸刺激），进而增加妊娠期糖尿病风险。